At a Glance
- ACA enhanced premium tax credits expire Dec. 31, 2025, with no extension deal in place.
- Millions of Americans risk higher premiums and loss of coverage.
- State premiums could jump up to 69 % (Arkansas) or rise 41 % in Washington.
- Why it matters: The expiration threatens to reverse record enrollment gains and push millions into higher costs or uninsured status.
After months of fighting, the deadline for the Affordable Care Act’s enhanced premium tax subsidies has arrived. Congress had until Dec. 31, 2025 to extend the credits, but Republicans left for recess on Dec. 19 without a deal. The result: many Americans face a sharp rise in health-plan costs or lose coverage entirely.
Congressional Deadlock
The battle over the subsidies split the GOP, with conservatives opposing ObamaCare and moderates trying to keep constituents satisfied. Mike Johnson (R-La.) sided with opponents of an extension, while four Republicans joined Democrats in a discharge petition to force a floor vote. The House is likely to pass the extension, but the Senate may not.
Enrollment, Premiums, and Uninsurance
Enhanced credits drove record enrollment in 2025, with 24 million people on ACA plans. The subsidies lowered monthly costs, even allowing many to pay $0 for premiums, and expanded eligibility to incomes above 400 % of the federal poverty level. Without the credits, KFF projects premiums will rise 26 % on average, with annual payments potentially doubling, up 114 % or $1,016, and between 2.2 million and 7.3 million people may drop coverage.
- Young adults will see the greatest rise in uninsurance rates.
- Black non-Hispanic people are projected to see a 25 % increase.
- Those earning 250-400 % of the FPL could gain 26 % in uninsurance.
State-by-State Premium Shifts
| State | Benchmark Plan Increase |
|---|---|
| Arkansas | 69 % |
| Washington | 41 % |
| Tennessee | Higher than Washington |
| Mississippi | Higher than Washington |
| Alaska | Lowest |
| Vermont | Lowest |
| New York | Lowest |
| District of Columbia | Lowest |
California sign-ups fell 32 %, Massachusetts lost about 13,000 enrollees, and Mississippi expects 200,000 to drop coverage.
Potential Legislative and State Responses
The House’s discharge petition could lead to a three-year extension, but Republicans want enrollment restrictions like income caps and minimum premium payments. State leaders say they’re ready to adapt. Pat Kelly, executive director of Your Health Idaho, said:
> “We stand ready to move mountains, if needed, to make sure that Idahoans receive all the savings that they’re eligible for.”
Jessica Altman, executive director of Covered California, warned:
> “Even a clean extension of the enhanced premium tax credits takes reloading everything in the system, resending notices to all the consumers, giving people time to come in and shop and change their plans … even that you’re talking about weeks, if not a month or longer.”
Key Takeaways
- The ACA subsidies expire Dec. 31, 2025, threatening to reverse record enrollment.
- Premiums could rise 26 % on average, with some states seeing increases up to 69 %.
- Between 2.2 and 7.3 million people may lose coverage unless Congress acts.
The coming weeks will determine whether millions can keep the savings that helped bring millions into coverage in the first place.
